A 78-year-old woman with coronary artery disease and severe chronic obstructive pulmonary disease is admitted to the hospital with painless jaundice. CT scan reveals the presence of multiple lesions in the liver, suggestive of metastases, and a nearly obstructing upper rectal mass. Colonoscopy demonstrates a large, ulcerated tumor in the proximal rectum and a residual lumen of less than 1 cm in diameter. While in the hospital, the patient develops a large bowel obstruction. What is the best treatment modality for this patient?

Question

Quizplus · Accepted Answer

Given the patient's advanced age, comorbid conditions, and the presence of metastatic disease, a less invasive approach such as the placement of a rectal self-expanding metal stent is the best treatment modality. This option provides immediate relief of the obstruction with minimal risk compared to surgery or immediate radiation therapy, which could be more taxing on the patient's health and recovery.

A 78-Year-Old Woman with Coronary Artery Disease and Severe Chronic